Healthcare Provider Details

I. General information

NPI: 1447269790
Provider Name (Legal Business Name): WEST BEND SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3212 PLEASANT VALLEY RD
WEST BEND WI
53095-9274
US

IV. Provider business mailing address

N74W12501 LEATHERWOOD CT
MENOMONEE FALLS WI
53051-4490
US

V. Phone/Fax

Practice location:
  • Phone: 262-334-6165
  • Fax: 262-334-1658
Mailing address:
  • Phone: 414-777-0417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUSAN CAMPBELL
Title or Position: SENIOR VICE PRESIDENT, SERVICE LINE
Credential:
Phone: 414-805-2230